2014 Veterans Health Administration controversy
On June 27, 2014, Obama's Deputy Chief of Staff, Rob Nabors, reported "significant and chronic system failures" and a "corrosive culture" inside the Veterans Health Administration.
[39] Veterans Affairs officials warned the Obama-Biden transition team in the weeks after the 2008 presidential election that the department should not trust the wait times that its facilities were reporting.
The Austin scheduler said that said "zeroing out" was a practice of falsifying information in the VA's records system that Washington officials used to monitor patient wait times.
A VA Office of the Medical Inspector report from December 2013 showed a dramatic change in March 2013 of the number of appointments booked within the 14-day window for the Fort Collins, Colorado outpatient clinic.
"[42] As of June 23, 2013, the United States Office of Special Counsel is investigating reports that two schedulers at the Fort Collins facility were reassigned to Wyoming after they refused to comply with instructions to falsify information about patient wait times.
[46][47] An audit from the Secretary of Veterans Affairs said, "some front-line, middle, and senior managers felt compelled to manipulate" records to meet performance goals.
Gina S. Farrisee, VA assistant secretary for human resources and administration, admitted in her written comments that the department needed to do better at holding executives accountable.
The independent chair of the Senate Veterans Affairs Committee, Bernie Sanders, said, "No organization the size of VA can operate effectively without a high level of transparency and accountability.
Investigations by the Office of Special Counsel supported claims such as high levels of bacteria at a clinic and an 8-year wait for a VA psychiatric inpatient to receive an initial evaluation.
U.S. Special Counsel Carolyn Lerner wrote in the letter that "These cases are part of a troubling pattern of deficient patient care at VA facilities nationwide, and the continued resistance by the VA, and [Office of Medical Inspector] in most cases, to recognize and address the impact on the health and safety of veterans" and that "veterans' health and safety has been unnecessarily put at risk" by the "harmless error" defense.
OSC substantiated numerous claims of unsafe practices at Jackson, Mississippi VA facilities including improper credentialing and illegal prescribing of narcotics.
Lerner said that "Despite confirming the problems in each of these (and other) patient-care areas, the VA refused to acknowledge any impact on the health and safety of veterans seeking care.
"[55] Acting VA Secretary Sloan Gibson said that he accepted the OSC's recommendations and had directed a review of the Office of Medical Inspector that was to be completed in two weeks.
Democrats, led by Senator Patty Murray, have aggressively sought more money for veterans' services since the second term of President George W. Bush.
Republican Representative Jackie Walorski said that the VA had "bureaucracy run amok" and noted a case in Atlanta where "two top officials were able to retire early and three were reprimanded" over three preventable deaths.
[62] The House members who sponsored the bill argued that, although federal workers can be fired, the process is extremely lengthy, sometimes taking years, and that the officials who are "under scrutiny for neglecting veterans actually received tens of thousands of dollars in bonuses and positive performance reviews.
"[63] Florida Republican Representative Jeff Miller, who sponsored the bill, said that "this bill would simply give the VA Secretary the authority to fire or demote VA Senior Executive Service employees based on performance, similar to the authority the Secretary of Defense already has to remove military general officers from command or how I am able to fire someone who works for me on my staff.
"[69] On June 11, 2014, the Senate voted 93–3 to pass the Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, the bill written by Senators McCain and Sanders to reform the VA.[70] Chairman of the House Committee on Veterans Affairs Jeff Miller said that "many of the provisions included in today's Senate-passed bill are based on ideas that have already cleared the House, so I'm hopeful both chambers of Congress can soon agree on a final package to send to the president's desk.
House Speaker John Boehner and American Legion national commander Daniel Dellinger also commented that new VA secretary would need Obama's support to make changes in the VA.[74][75] McDonald was sworn into office on July 30, 2014.
The VA announced the week prior to Gibson's statement that two supervisors would be fired and four other employees would be disciplined for their roles in falsifying data in Colorado and Wyoming.
"This bill covers a lot of ground, from expanding survivor benefits and educational opportunities, to improving care for veterans struggling with traumatic brain injury and for victims of sexual assault," said Obama, and gives the VA Secretary "more authority to hold people accountable... so that he can move quickly to remove senior executives who fail to meet the standards of conduct and competence that the American people demand.
"[82] In his spoken testimony, Griffin said that in "three-fourths (of the VA facilities investigated for falsification of wait time data), we're pretty confident that it was knowingly and willingly happening, and we're pursuing those."
We at VA are committed to fixing the problems and consistently providing the high quality care our Veterans have earned and deserve in order to improve their health and well-being."
[84] On September 18, 2014, VA published the Federal Register its intention to increase the annual salaries of new physicians and dentists by up to $35,000 as part of a nationwide recruitment effort to hire more doctors and improve veterans' access to care.
VA Secretary Bob McDonald said the department needs new doctors, nurses and clinicians for 28,000 jobs authorized by Congress in the 2014 Veterans Access, Choice and Accountability Act.
On a February 15, 2015 airing of Meet the Press, McDonald claimed that 60 U.S. Department of Veterans Affairs employees had been fired due to the VA's wait time scandal.
"[94] On April 27, 2017 President Trump signed Executive Order 13793, titled "Improving Accountability and Whistleblower Protection at the Department of Veterans Affairs.
Compounding this problem, more liberal eligibility standards allow veterans to get treatment for chronic conditions of aging like heart disease and Parkinson's.
[96] "Setting a benchmark of 14 days to see a new primary care doc at a VA hospital or clinic in Boston or Northern California may be completely reasonable," wrote Longman.
"[96] Economics Nobel laureate Paul Krugman said that the scandal came about because conservatives did not like the fact that the VHA system, which is "an island of socialized medicine," is working well, so they seized on wait times as "a gift from God" to discredit the VHA.... "It's still true that Veterans Affairs provides excellent care, at low cost," ... "Those waiting lists arise partly because so many veterans want care, but Congress has provided neither clear guidelines on who is entitled to coverage, nor sufficient resources to cover all applicants.
